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Business Acquisitions (Narrative) (Detail) (USD $)
 12 Months Ended
Dec. 31, 2012
Y
Company
Dec. 31, 2011
Company
Business Acquisition Actual Revenue And Pre Tax Income Loss [Line Items]    
Number of physician group practices acquired 16 10
Business acquisition, total consideration $ 451,100,000 $ 159,500,000
Cash consideration 436,400,000 146,500,000
Contingent consideration 14,700,000 13,000,000
Goodwill recorded in connection with acquisitions 414,300,000 138,600,000
Additional intangible assets 48,200,000  
Fixed assets 600,000  
Other liabilities 12,000,000  
Contingent consideration payments related to prior-period acquisitions 14,700,000  
Payments due on contingent purchase price provisions 2017  
Time period for achievement of certain performance measures for payment of contingent consideration, years 5  
Assumed payment probability of contingent consideration payment 100.00%  
Range of the undiscounted amount under contingent consideration agreement, low 0  
Range of the undiscounted amount under contingent consideration agreement, high 15,900,000  
Additional contingent consideration for the Achievement of certain Performance Measures 5,000,000  
Recorded Additional contingent consideration for the Achievement of certain Performance Measures 0  
5.0 million contingent consideration agreement [Member]
    
Business Acquisition Actual Revenue And Pre Tax Income Loss [Line Items]    
Contingent consideration 0  
Minimum [Member]
    
Business Acquisition Actual Revenue And Pre Tax Income Loss [Line Items]    
Assumed discount rates for acquisition-date fair value 3.00%  
Eligibility criteria for payments of contingent purchase price (in years) 3  
Maximum [Member]
    
Business Acquisition Actual Revenue And Pre Tax Income Loss [Line Items]    
Assumed discount rates for acquisition-date fair value 5.00%  
Eligibility criteria for payments of contingent purchase price (in years) 5  
Prior-Period Acquisitions [Member]
    
Business Acquisition Actual Revenue And Pre Tax Income Loss [Line Items]    
Contingent consideration 39,000,000  
Additional intangible assets   22,500,000
Fixed assets   400,000
Contingent consideration payments related to prior-period acquisitions 42,900,000  
Contingent consideration payments related to prior-period acquisitions 14,800,000 11,500,000
Contingent consideration for Prior Period Acquisition 1,300,000  
Other liabilities   $ 2,000,000